Authors: Lisa Pilnik, Margot Cronin-Furman, and Vikki Wachino
Health care is essential for all youth and young adults, but can be especially important for youth involved in the justice system. Young people who are leaving corrections are more likely than their peers to have physical and mental health conditions such as asthma, hypertension, anxiety, and depression. Research has also linked incarceration with poorer health in adulthood, ranging from physical limitations to mental health conditions. Access to healthcare coverage and services can not only improve health outcomes for this population but has been shown to impact rates of contact with the criminal justice system, including incarceration.
Many youth who are incarcerated may be eligible for Medicaid or CHIP, but in the past, these programs were barred from covering services during incarceration. Policies included in the Consolidated Appropriations Act of 2023 (CAA) and effective January 1, 2025, help ensure that youth can receive needed services by authorizing Medicaid and CHIP to cover screening, diagnostic, and case management services for youth starting 30 days prior to release from incarceration. Juvenile justice leaders have described the changing role of Medicaid and CHIP as a way to minimize gaps in care transitions, ensure that youth are connected to community based services at reentry, and ultimately, support communities.
HARP’s brief describes how these policies can improve people’s health and public safety and how they can be implemented effectively. The paper describes how access to health care can advance health and safety, and highlights three key youth continuity of care implementation strategies, drawing on the experiences of three states, New Mexico, North Carolina and Massachusetts:
- Engagement and collaboration with community providers and agencies across sectors;
- Creating processes to ensure eligible youth are enrolled in Medicaid promptly and can access all appropriate services (including administrative steps to ensure services will be covered and paid for by Medicaid); and
- Early and continuity-focused planning for release so that there are no gaps in needed services when youth return to their communities.
Each state’s work to achieve these strategies is described in the paper. The paper also highlights evidence-based approaches to identifying the needs of youth and young adults and providing post-release services, which are discussed in its appendixes.
HARP has also created key resources for adult justice system leaders to support implementation, including an operational checklist, an overview of key implementation elements, and Frequently Asked Question (FAQ) documents created for jails and state prison systems.
Reach out to HARP if your state needs technical assistance or has questions about implementation.